Trauma assessment process for pregnant women

Trauma assessment process for pregnant women 1. The process is divided into several key stages and is designed to help doctors quickly and accurately assess the patient's condition and take corresponding treatment measures.

Edited at 2024-11-05 14:55:10

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Trauma assessment process for pregnant women

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Outline

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preliminary assessment airway breathe cycle disabled exposure, contact

Traumatic cardiac arrest Choose a channel above the diaphragm (intravenous infusion vs bone marrow aspiration); Consider a management transfusion protocol (MTP); Consider thoracotomy if necessary; Initiate advanced cardiac life support (ACLS); early intubation; Left lateral decubitus position (LUD); Peripartum cesarean section was performed 4 minutes after cardiac arrest; Call the obstetrics and gynecology and neonatal intensive care teams.

Unstable state (loss of airway, GCS < 9, BP < 80/40, HR < 50 or > 140, FHR < 110 or > 160) Airway: For early intubation, consider using a smaller endotracheal tube diameter (6-6.5 mm); Breathing: Supplement oxygen, perform chest drainage if necessary; Circulation: Establish intravenous access above the diaphragm, perform a transfusion management protocol (MTP) if necessary, place in the left lateral decubitus position (LUD), stop bleeding, and administer tranexamic acid (TXA); Fast ultrasound (FAST); Perform chest X-ray (CXR) and pelvic X-ray (PXR) when necessary; If the fetus is viable, call the obstetrics and gynecology and neonatal intensive care teams; Initiate fetal heart rate monitoring (EFM): If fetal heart rate monitoring is level III, perform emergency cesarean section; Laboratory testing: complete blood count (CBC), coagulation function test, fibrinogen, blood group and cross-match, KB test if Rh negative; Surgical intervention as needed;

Stable state (preliminary assessment shows no abnormality) Conduct a secondary assessment; Establish intravenous access above the diaphragm; Laboratory tests: complete blood count (CBC), coagulation function test, fibrinogen, blood group and cross-match, and KB test if Rh negative; Imaging examination: fast ultrasound (FAST), bedside fetal ultrasound, X-ray and CT scan if necessary (target dose <5 rad); If Rh negative, give Rh immune globulin (Rhogam); Perform a pelvic examination if necessary; Start fetal heart rate monitoring (EFM); Routine fetal ultrasound;

Monitor for 4 hours minor trauma; No physical examination findings; Fetal heart rate monitoring is reassuring; Less than 1 contraction every 10 minutes;

Monitoring for more than 24 hours major trauma; Physical examination findings: uterine/abdominal tenderness, vaginal bleeding, rupture of amniotic fluid (ROM); Having multiple contractions every 10 minutes; Fetal heart rate monitoring results are not reassuring (category II); Fibrinogen < 200;

emergency caesarean section Fetal distress, manifested by grade III fetal heart rate monitoring results Uterine rupture Placental abruption with significant bleeding Fetal malposition accompanied by premature birth